# LEA GEORGATOS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1457988115
- **Gender:** F
- **Credential:** ATC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2255A2300X | Athletic Trainer | 003935 | NY | — |
| 2255A2300X | Athletic Trainer | 2000037008 | NULL | Yes |
| 2255A2300X | Athletic Trainer | 2000037008 | — | Yes |
| 2255A2300X | Athletic Trainer | 25MT00269500 | NJ | — |

## Other

- **Enumeration date:** 03/24/2020
- **Last updated:** 03/24/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 003935 | NEW YORK STATE EDUCATION DEPARTMENT - OFFICE OF THE PROFESSIONS | NY |
| 01 | — | 2000037008 | BOARD OF CERTIFICATION | — |
| 01 | — | 25MT00269500 | STATE OF NEW JERSEY / NEW JERSEY DIVISION OF CONSUMER AFFAIRS | NJ |